Book review

eresting collection of essays. Within the brief space of less an 200 pages medical, psychological and moral issues are rveyed. Medically his speculations are fresh and stimulating, ^e theory of the " safety valve " is full of interest, whilst ls reflections upon rest and exercise and food are the wellfi 1 ?rec^ Noughts of maturity. Dr. Weber, in the psychological u, offers a balanced criticism of the Freudian thesis', and fairly points to the riot of speculation which has tended obscure the truth contained in the theories first put forward y -^reud. In the moral field Dr. Weber's deductions from his

1935. Price 6s.?The versatility, learning and wide range of this well-known writer, who has covered so much and varied ground in the past forty years, has given us an eresting collection of essays. Within the brief space of less an 200 pages medical, psychological and moral issues are rveyed. Medically his speculations are fresh and stimulating, ^e theory of the " safety valve " is full of interest, whilst ls reflections upon rest and exercise and food are the wellfi 1 ?rec^ Noughts of maturity. Dr. Weber, in the psychological u, offers a balanced criticism of the Freudian thesis', and fairly points to the riot of speculation which has tended obscure the truth contained in the theories first put forward y -^reud. In the moral field Dr. Weber's deductions from his ^ Clples will surely appear to most men as contrary to right son. For having arrived at the position that man, having quired a measure of control over the forces of Nature, he as a companion to Some Thoughts of a Doctor ed last year, though the subjects of the majority of 45 the essays in this volume are more strictly medical. All are interesting, many are provocative of thought, and some provide sound medical teaching in a most palatable form. Their subject-matter bears tribute to the author's wide interests and deep learning.
They range from early published descriptions of thrombo-angiitis obliterans and the probable effect of tight corsets in the etiology of chlorosis to the modern conceptions of endocrine neoplastic dysfunction and the pathology of splenic reticulosis. If there is one fault to be found with these essays it is the author's over-free use of parenthetical brackets, but even this will probably be regarded by those who know Parkes Weber as a characteristic exemplifying the inadequacy of the spoken or written word in the function of expression of his rapid flights of thought. The book will afford pleasure and stimulation to all, and will assuredly be acquired by many who know the author as a living memento of his great personality.
A Synopsis of Physiology. By A. Rendle Short, M.D., F.R.C.S., and C. I. Ham, F.R.C.S. Second Edition. Edited by C. L. G. Pratt. Pp. vi., 312. Illustrated. Bristol: John Wright & Sons Ltd. 1936. Price 10s. 6d.?Excellent work has been done in bringing this useful little book up to date, and many improvements are included. It should now take its place in popularity beside its well-known companion volumes on Medicine and Surgery, for it is worthy of the position. The English is at times too familiar, and it is a pity that so many minor errors have been overlooked in the proof reading. Students will be alarmed at the size of their surface area if they use the formula given. The weight should, of course, be stated in kilograms not in grams, but the more widely-used nomogram deserves mention as well or perhaps instead of the formula.
The use of italics is sometimes unfortunate. Eor instance, to say that " In any solution, product of H ions and OH ions is constant " only emphasises the lack of the word " aqueous " after " any " ; and when it is decided in Chapter I that creatinine " is not formed from creatine in the body " it is inconsistent as well as pointless to revive the controversy in Chapter XI by quoting authors who say that it does occur and is a normal process. In the section on " Respiration " it is a little disappointing to see the retention of the obsolete term " infundibulum" and the mythical idea of an intrathoracic pressure that is normally negative. The latter, and what is described is more truly interpleural pressure, cannot exist until the space for it is artificially produced. But Perhaps we are mistaken and partial double pneumothorax is a normal condition, as we infer from the information at the e of the same paragraph that " in newborn infants lungs completely fill chest cavity, and negative pressure is only gradually produced." Ideas of C02 transport should be lfu a^ow f?r the carbonic anhydrase theory for nough it is mentioned no attempt is made to account for it. e explanation of Cheyne-Stokes Respiration is selfcontradictory. Few will deny the necessity of mentioning some of the outstanding examples of experimental evidence, the difficult task of selection and condensation has been Oft the whole well done, but occasionally the evidence offered not above question. The three reasons given for the summary jection of Cannon's theory of adrenaline action must be r entioned. The first is evidence that has, we think, not been peated, but the second is widely regarded as unsound, and third is a mere surmise. These criticisms, although by no ans exhaustive, will not detract greatly from the value of s well-arranged book if it is used as its authors intended in junction with, or subsequent to, a normal medical course ln Physiology. and of chronic rheumatism, with his conception of alkali depletion resulting from the progressive accumulation of bacteria, and of streptococci in particular, beyond the saturation point in susceptible individuals. In this he makes out a good case for his conception of a syndrome of chronic streptococcal toxsemia, and there is never any doubt of the honesty of his search for a rational treatment, both prophylactic and curative.
There will, however, be much disagreement with his explanations of phenomena observed, and with the numerous unorthodox conceptions of the physiological and immunological processes by which he justifies many of his therapeutic procedures. The book is probably not intended as a scientific exposition of the streptococcal toxsemic theory of the causation of chronic rheumatism, but rather as a contribution to the practical handling of this disease. As such its study by the practitioner will provide him with many new view-points, and probably also with a more comprehensive picture of these manifestations of chronic ill-health than is usually obtainable from the more orthodox text-books of medicine. This is the first annual report of the British Committee on Chronic Rheumatic Diseases appointed by the Royal College of Physicians, and consists of a number of original articles and critical commentaries on different aspects of this disease, each written by an authority on the particular subject under discussion. These articles are preceded by a report of the sub-committee on classification and nomenclature, and if the volume contained nothing more than this its value would still be assured. As is inevitable in any collection of papers of this type, the standard of medical value and of literary ability varies with the different authors, but every chapter bears the imprint of discriminating analysis and open-minded investigation. This report is concerned mainly with discussions of the various hypotheses of the causation of chronic rheumatism, and with some of its special manifestations. Very little is said of treatment, a fuller discussion of this eing promised in the next report. As an up-to-date and authoritative summary of our knowledge of some of the Problems of chronic rheumatism this little volume will be Scorned by every practitioner in the country, and its presence on the shelves of consultants (medical, surgical u orthopaedic) is almost inevitable. Illustrations are ,?w but carefully selected, the paper is of good quality, (4) irs^orical Survey, (2)  There are 95 of these diagrammatic sketches, varying from the incidence of the sun's rays at various times of the year to those showing sections of the drainage systems of dwelling-houses, typifying the application of the building bye-laws relating to water closets, fittings, soil pipes, etc. The chapters on food inspection and fish inspection are well written, and the one on disinfestation is up to date concerning cyanide fumigation by local authorities in the attack on the bed bug. Price 10s. 6d.?A good book, clearly and concisely written and well printed and illustrated. The subject-matter is well presented, and the book should be read not only by radio-therapists but also by the general surgeon, so that, as the author says, the X-ray Department may no longer be looked upon as the " Ante-room to the Post-Mortem Room.' The many methods of treatment are mentioned, but one wishes that the author had given some idea of the results obtained by each method in the various lesions, so that one might form a better idea of which method to use. Some of the physics might, perhaps, have been dispensed with, since the practising radio-therapists, for whom this book is primarily intended, already possess this knowledge, but since these chapters are written in simple language they will, no doubt, be of great value to D.M.R.E. candidates. The general arrangement of the book is good, the bibliography full, the index adequate, and the book itself of a convenient size. \\r ai*d Dangerous Diseases of the Ear. By R. R. oods, P.R.C.S. Pp. x., 188. Illustrated. London: Oxford diversity Press. 1936. Price 15s.?A simpler title for this infl would have been " Aural Inflammation," for only ? ammatory conditions are included. The book opens with r y pages devoted to anatomy (physiology is not mentioned) ' methods of examination. These are good, though dia ?W unnecessarily detailed. The next section deals with gnosis and treatment : great care is expended on the mer> and it is very competently set out, but the latter is are sketchy ; for example, one and a quarter pages only th ^1Ven treatment of acute suppurative otitis media?and author fails entirely to distinguish between " wet " (i.e. Ringing) and " dry " (or hygroscopic) methods. We admire, 0? ^ever, the restraint he has observed in avoiding descriptions ?l>erative technique on which space is frequently wasted in ? , this nature ; though in the last part of the book his erest in such details is not so well suppressed. The final v J Pages are devoted to intracranial complications, again d0 described, if we admit that a certain degree of mus^ be allowed : it would be unwise to rely too Pncitly on his description for the differential diagnosis of r>r lri-.a^scess> sinus thrombosis, etc., but naturally the Th ^oner would rarely accept such a responsibility unaided, " tk au^0r is annoyingly inexact in his diction : he writes of m'dHl ^rum " when he means "the membrane," of "the of (far " when he means "the tympanic cavity," and cc a pulsating perforation," whatever that may be : ai^ast?idism " and " meningism " we encounter frequently, qi , Vays with the suspicion that he is not quite sure whether ex S i^1 or meningitis is present or not. The book is col ,t!y brought out, and profusely illustrated?indeed, the ar^u.r ^lustrations must excite wonder and envy equally : is a full and competent exposition of the subject. To During the intervening years so many advances have been made in midwifery and gynaecology ? especially in the field of the endocrine control of the female generative organs that numerous alterations have been necessary in the text of the second edition, and several new chapters have been added. A very large amount of information has been compressed into a comparatively small compass, and the book has been tabulated throughout, making it especially valuable to students preparing for examination. The authors have, as a rule, limited themselves to a statement of the most generally accepted opinion on any point that is controversial. They have given little space to discussing theories, nevertheless the subject-matter is up to date and in line with modern teaching. The chapters on the pathology of pregnancy and the complications of the puerperium are particularly good. The remaining nine chapters deal with gynaecology and the feeding of infants. Though the space allowed for these important subjects is somewhat limited, the authors give a concise and fairly complete account of the most important gynaecological diseases. The chapter on operative gynaecology is too short, and the operations described too few to bring it up to the standard of the rest of the text-book, and in the opinion of the reviewer it would have been better to omit it and to refer the reader to the larger text-books which specialize in this branch of operative surgery. This book can be strongly recommended to the student of medicine and to the practitioner who requires a short and up-to-date handbook on obstetrics and gynaecology. Price 12s. 6d.?This volume, dealing with the work carried out on the isolation of insulin, its purification, and its physiological action, will be of the utmost value to scientists and physicians alike. The authors start the book with an historical account of the clinical and pathological researches which led to the conclusion that the pancreas is related to that insidious disease diabetes mellitus. As far back as 1686 Brunner suggested that the pancreas was in some way related to fat and carbohydrate metabolism ; Opie and others later described the changes taking place in the islets of Langerhaus in diabetics. The clinical and pathological investigations were followed by attempts to isolate the principle concerned in regulating the are sm carbohydrates and fats ; numerous researches rp described in which pancreatic extracts were made, and eel to relieve symptoms of diabetes when administered fi "^anting and Best, with their co-workers at Toronto, y succeeded, by modifying a method introduced by T)r P'. in isolating an active principle by fractional to C1 ^ ation of extracts with alcohol. It is perhaps invidious t a^e sPecial reference to other workers, but it is undoubtedly ^ e that H. W. Dudley, whose recent early death is much to regretted, did much valuable work in this field of research. v ? mode of action of insulin is dealt with in Section 7, and 10us theories discussed. Biological methods of assay are fussed in some detail. One of the outstanding features it excellent volume is the extensive bibliography which j Contains, and which will prove of great utility to those lo ?St6d *n the study of diabetes mellitus. The book has a WeVnt0reSt' aS "^r" *s an student of Bristol University, of i7?Pe that this volume will shortly be found in the library a physicians and bio-chemists.